title: Ten-year trends in the use of catheter ablation for treatment of atrial fibrillation vs. the use of coronary intervention for the treatment of ischaemic heart disease in Australia.
abstract: OBJECTIVE
  Percutaneous coronary intervention (PCI) and catheter ablation are well-accepted therapeutic interventions for treatment of coronary artery disease and atrial fibrillation (AF), respectively. We sought to examine temporal trends in the provision of these services over the past decade in Australia.
  
  
  RESULTS
  A retrospective review of the numbers of PCIs and AF ablations from 2000/01 to 2009/10 was performed on data from three sources: the Australian Institute of Health, Welfare and Aging (AIHW), Medicare Australia database (MA), and local records at a high volume tertiary referral centre (RMH) for AF ablation. Linear regression models were fitted comparing trends in population-adjusted procedural numbers over the 10-year period. There was a 5% per year population-adjusted increment in PCIs over 10 years from both the AIHW and MA sources, respectively (P < 0.001). This was similar to the growth rate of all cardiovascular procedures (AIHW: 5.1 vs. 3.8%/year, P = 0.27). Atrial fibrillation ablations showed a 30.9, 23.2, and 39.8% per year population-adjusted increment over 10 years from the AIHW, MA, and RMH sources respectively (P < 0.001 for all). Growth of AF ablations was significantly higher than PCIs (P < 0.001 for AIHW and MA sources) and all cardiovascular procedures (AIHW: 30.9 vs. 3.8%/year, P < 0.001).
  
  
  CONCLUSIONS
  The provision of catheter-based AF ablation services in Australia has increased exponentially over the past decade. Its annual growth rate exceeded that of PCIs and all cardiovascular procedures. Given the increasing epidemic of AF, these data have critical implications for public health policy assessing the adequacy of infrastructure, training, and funding for AF ablation services.
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, University of Melbourne, Grattan St, Parkville, Victoria 3050, Australia.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.forename: Tomos E
authors.initials: TE
authors.lastname: Walters
authors.forename: Karen
authors.initials: K
authors.lastname: Halloran
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Morton
authors.forename: Graham
authors.initials: G
authors.lastname: Hepworth
authors.forename: Christopher X
authors.initials: CX
authors.lastname: Wong
authors.forename: Peter M
authors.initials: PM
authors.lastname: Kistler
authors.forename: Prashanthan
authors.initials: P
authors.lastname: Sanders
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Kalman
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001315:Australia / Q000453:epidemiology; D017115:Catheter Ablation / Q000706:statistics & numerical data / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D016014:Linear Models; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D020380:Needs Assessment / Q000639:trends; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Atrial fibrillation; Catheter ablation; Coronary artery disease; Ischaemic heart disease; Percutaneous coronary intervention